Organization Active NPI

Life, Inc.

  • Community/Behavioral Health Agency
  • Washington, NC
National Provider Identifier
1639219488
Registry record updated Dec 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
HC1543 Issued in NC
Legal business name
LIFE, INC.
Practice address
1829 Carolina Ave
Washington, NC 27889-3369
Phone
(252) 974-2600
Fax
(252) 974-1211
NPI assigned
Feb 8, 2007
Last updated
Dec 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James Walker
Title
Director of Contract Services
Phone
(919) 778-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X HC1543 NC Primary

Addresses

Primary practice location

1829 Carolina Ave
Washington, NC 27889-3369

Mailing address

2609 Royall Ave
Goldsboro, NC 27534-8615
Phone (919) 778-1900

Other identifiers 1

IdentifierTypeStateIssuer
3408694MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Life Inc48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

1829 Carolina Ave
Washington, NC 27889
Phone (252) 974-2600

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513382400000",
    "number": "1639219488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 ROYALL AVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275348615",
            "telephone_number": "919-778-1900",
            "fax_number": "919-778-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 CAROLINA AVE",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893369",
            "telephone_number": "252-974-2600",
            "fax_number": "252-974-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2017-12-16",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACT SERVICES",
        "authorized_official_telephone_number": "919-778-1900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "HC1543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408694",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.